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Feds: 2016 SBC rules are coming 'in the near future'

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Federal regulators may update the Summary of Benefits and Coverage (SBC) regulations for the 2016 plan year, but they will probably wait until 2017 to re-do the SBC itself.

The Employee Benefits Security Administration (EBSA), the Internal Revenue Service (IRS) and the U.S. Department of Health and Human Services (HHS) talk about their SBC work in a note on the EBSA website.

Officials presented the note as an answer to frequently asked questions (FAQs) about implementation of the Patient Protection and Affordable Care Act (PPACA).

An SBC is supposed to be like a clear, standardized “nutrition label” for health plan, to help consumers compare plans on an apples-to-apples basis. The current includes a description of basic plan features, such as deductibles, co-payment rules and coinsurance requirements, and two scenarios illustrating how the plan might work in real life. One of the standard scenarios used is having a baby. The other is care for a consumer with type 2 diabetes.

SBC scenarios

Regulators have proposed adding a scenario of interest to young, healthy people, such as care for a broken foot.

Some consumer groups would prefer to see officials add a catastrophic care scenario, such as a case of breast cancer treated with surgery, radiation therapy and chemotherapy.

Originally, federal agencies had wanted to get a major update ready for the 2016 plan year, but the National Association of Insurance Commissioners (NAIC) asked the agencies to put off making any big changes until 2017.

The federal agencies are also updating the Uniform Glossary, or guide to health insurance terms, that’s goes to consumers along with the SBC.